Do you misplace things?
Are you easily distracted and often forget to complete tasks or attend appointments; or do you know someone who fits this description?
Have you wondered if you have Attention Deficit Hyperactivity Disorder (ADHD)?
In many cases these symptoms are simply the effect of our hectic, fast paced and over extended lives. [Are you reading this on your cell phone while you should be doing something else?] However, for 2.5 percent of adults these symptoms are due to ADHD.
So how can you tell if you have adult ADHD?
In an effort to simplify and improve the diagnosis of ADHD, the American Psychiatric Associated updated the diagnostic criteria in the latest update of the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5), which was released in 2015. One major change is that the diagnostic criteria now reflect situations that are commonly encountered by adults. Previously, the criteria were developed for children/adolescents and had to be modified for use in adults.
The second major change is that adults now need to have only five symptoms to meet criteria. Children and adolescents (under age 17) continue to require six symptoms to make a diagnosis.
What has not changed is that the symptoms must be persistent (lasting for at least six months) and must interfere with functioning or negatively impact social and academic and/or occupational activities.
Got all that?
Okay, so you are probably wondering, "what are the symptoms"?!
The symptoms fall into two separate categories, which can either be related to A) inattention or B) hyperactivity-impulsivity or both. To be diagnosed with ADHD as an adult you only need five symptoms from either single category (however, you may well have symptoms from both categories):
1)Failing to pay close attention to details, making careless mistakes at work or school and during other activities
2)Difficulty sustaining attention in tasks and/or recreational activities
3)Not listening when spoken to directly (even in the absence of distraction)
4)Not able to follow through on instructions and failing to finish tasks at home and/or duties at work
5)Difficulty organizing tasks and activities
6)Avoiding, disliking and being reluctant to engage in tasks that require sustained mental effort
7)Losing things that are necessary for tasks and activities
8)Easily distracted by extraneous stimuli
9)Forgetfulness in daily activities
B) Hyperactivity and Impulsivity:
1)Fidgeting with, or tapping, hands or feet or squirming in seat
2)Leaving your seat in situations in which remaining seated is expected
3)Feeling restless in situations when it is inappropriate
4)Being unable to engage in leisure activities quietly
5)Feeling uncomfortable being still and appearing to be "on the go," as if "driven by a motor"
7)Blurting out answers before questions have been completed, completing other people's sentences and being unable to wait for your turn in conversation
8)Difficulty waiting for his or her turn
9)Interrupting or intruding on others
While everyone probably has experienced one or more of these symptoms from time to time, the important factor to make a diagnosis is their persistence (both longitudinally and across different settings). For example, the DSM-5 states that several of these symptoms must have been present prior to age 12. To clarify, you do NOT have to be diagnosed before age 12, however, there must be evidence of substantial childhood symptomatology.
Additionally, the DSM-5 states that symptoms must be present in two or more settings. For example, you must suffer from these symptoms both at home and at work/school and both with friends or family as well as your colleagues/classmates.
Finally, the DSM-5 diagnostic criteria requires that there must be clear evidence that the symptoms interfere with, or reduce the quality of social, academic and/or occupational functioning and that the symptoms cannot be a product of another mental or physical condition or substance abuse.
After reading the criteria and the symptoms, if you believe you may have ADHD you should speak with your primary care doctor or establish an evaluation with a psychiatrist. Many of the symptoms of ADHD overlap with other psychiatric disorders and it is important to get an accurate diagnosis prior to considering any treatment.
The subjective nature of the above symptoms and several other factors make diagnosing and treating ADHD challenging.
- You can read "Part Two: How a Psychiatrist Diagnoses and Treats ADHD in Adults" and how to overcome these challenges of ADHD here.
Dr. Goldenberg is an Addiction Psychiatry Fellow in Los Angeles and has written numerous articles about mental health and addiction topics. You can follow Dr. Goldenberg at docgoldenberg.com and on Twitter: @docgoldenberg